My dr. called me this morning. He stated that my white blood count was down and that he wanted me to decrease my cellcept from 4 per day to 3 per day. Is that good?

Saysusie

04-18-2007, 11:57 AM

Hi Sisterloudjoy38 :lol:
An increased white blood cell count (aka: WBC - Leukocyte count - white count) usually indicates that there is something wrong! An elevated number of white blood cells is called leukocytosis. Conditions or medications that weaken the immune system, such as Lupus, HIV infection or chemotherapy, cause a decrease in the white blood cells. The WBC count detects dangerously low numbers of these cells.
The WBC count is used to suggest the presence of an infection or leukemia and it is also used to help monitor the body’s response to various treatments and to monitor bone marrow function. A WBC count is normally ordered as part of the complete blood count (CBC), which is ordered for a wide variety of reasons. A WBC count also may be ordered to monitor recovery from or seriousness of an illness. Counts that continue to rise or to fall to abnormal levels indicate that the condition is getting worse. Counts that return to normal indicate improvement.
In your case, it sounds as if the count indicates improvement. If so, let me say Congratulations!! I hope that you continue to improve!!

Peace and Blessings
Saysusie

sisterloudjoy38

04-18-2007, 02:05 PM

Thanks for the good information. I did talk with my dr and he said I am doing better. The Lupus is stabilizing. My white blood count is normally at 2.5 and the decrease would be beneficial. So, now I am taking 3 cellcept pills. Which is 1500 mg a day. How greatful I am.

msdawnie44

04-19-2007, 07:18 AM

Saysusie;

Most recently...my ANA's were elevated quite a bit...as well as my white cell count....(WBC 12,500) and since I also have Epstein Barr....what questions do you think I should ask my doctor....I get my blood work done at least every 2 weeks...I am taking Plaquenil, cortesteroid, advil, thyroid, pain meds, nexium.....and an enhaler right now for bronchitus/walking pneumonia. Any advise.....??? Just want to know what questions to ask..and what to look for....I am however feeling better today. Thank you, GOD BLESS Dawn

Saysusie

04-19-2007, 03:22 PM

Hi Dawn;
One of the concerns with Epstein Barr is the fact that it plays a role in the emergence of two rare forms of cancer: Burkitt's lymphoma, and nasopharyngeal carcinoma. Epstein-Barr virus is in the herpes family of viruses and most people will become infected with EBV sometimes during their lives. Diagnosing EBV is done by considering the clinical symptoms of fever, sore throat, swollen lymph glands and your age. A physical examination may reveal an enlarged liver and/or enlarged spleen. The liver and spleen may also be tender. Laboratory tests should be done for confirmation. If your symptoms last more than 6 months, it is considered Chronic Epstein Barr (CEBV).
Blood findings may include an elevated white blood cell count, an increased percentage of certain white blood cells and a positive reaction to a "monospot test (a blood test to detect antibodies to the Epstein-Barr virus (EBV) antigens). The monospot test (one of the EBV tests) will be positive only during the acute phase of EBV infection. Other more sophisticated and rarely used antibody tests can tell the difference between acute and past infection with the virus. Antibody tests for EBV measure the presence and/or the concentration of specific EBV antibodies. In patients with auto-immune disorders (like Lupus and arthritis), the antibodies to EBV are usually elevated! Different laboratory tests can measure specific EBV antibodies. Some of these tests can be performed on a single sample of blood, while others compare different samples of blood over a period of time.

Some Questions You Could Ask Your Doctor:
Am I at risk of developing any of the two cancers listed above?
Does Lupus affect EBV (or vice-versa) and how?
What type of lab work was done to confirm EBV?
What does the result of the lab work mean (How does elevated ANA and WBC affect EBV and Lupus?)
What are the chances this could lead to some other major complication or that this infection will cause major complications in your lupus?
How will you know if your spleen has been affected?
How long does the contagious period of EBV last?
What precautions should be taken to minimize EBV disease being passed on to others?
What precautions should be taken to minimize the effect of EBV on Lupus or the effect of Lupus on EBV?

Perhaps someone will have some other questions that you should ask. Let me know if this has been helpful!

Peace and Blessings
Saysusie

msdawnie44

04-20-2007, 06:42 AM

Thank you....Saysuzie....I have already been diagnosed with Chronic EBV about 10 years ago via biopsy of my lymph nodes in my neck it came back full blown positive for EBV...and to this day it continues rear its ugly head at 2 times a year...but started getting worse when the LUPUS became very active.......I was also diagnosed with Lupus SLE about 6 months ago....so unfortunately I have the double whammy!!! I will ask my some questions that you suggested ...I go back next week for my 3 week check up. Thank you so much for your advise..it is always helpful. Would you suggest I see a Hemotologist?? Because my white cell count is contantly above 10,000 - 15,000 or higher and LUPUS ANA's are getting higher all the time...

God bless you!
Dawn

MARYCAIN

04-20-2007, 05:38 PM

Dawn, if you are on steroids (prednisone, solu-medrol, etc.), then the increased white blood cell count may be nothing to be concerned about. It is normal for people on steroids to have increases in their overall white cell count. Since you do have an EPV diagnosis, it would be a good idea for you to have a white blood count test with a manual differential. There are different types of white blood cells, and often, it is the type of white blood cell increase that is most significant. For instance if you have a large number of one type of white cells, that might mean they are overproducing and crowding out the other white types of white cells.

An ANA test can be confusing because of the way the numbers are reported. Since the test involves dilutions of a test sample, and the amount of test fluid is doubled with each dilution, the numbers (titer) double too. So the results double each time - 40, 80, 160, 320, 640, etc. The difference in 1:160 and 1:640 sounds huge, and it can be alarming. But it is basically two additional dilutions of the testing fluid, and may not represent any increase in disease activity. It's pretty common for the ANA to go up and down during the course of the disease, and it is not a good measure of disease activity, so many doctors don't retest it that often. A viral illness or a bacterial infection can also cause an increase in the ANA, and it can be affected by a lot of factors other than lupus activity. So other tests are normally used to monitor disease progression.